A case report of late perforation at the site of jejuno-jejunal anastomosis after laparoscopic Roux-en-Y gastric bypass surgery
| Autor: | Sarah Al Ben Ali, Khalifah Alyatama, Abdulrahman Al Kandari, Abdulwahab Al Kandari, Sarah Al Hendi, Mohammad Qasem |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.diagnostic_test Gastric bypass surgery business.industry Perforation (oil well) Anastomosis medicine.disease medicine.disease_cause Roux-en-Y anastomosis Surgery Bowel obstruction 03 medical and health sciences 0302 clinical medicine 030220 oncology & carcinogenesis medicine 030211 gastroenterology & hepatology Dumping syndrome Abscess Laparoscopy business |
| Zdroj: | International Journal of Surgery Open. 29:20-23 |
| ISSN: | 2405-8572 |
| DOI: | 10.1016/j.ijso.2020.11.014 |
| Popis: | Introduction Roux-en-Y gastric bypass (RYGB) is one of the most commonly performed weight-loss surgeries worldwide. Its common complications include bowel obstruction, anastomotic strictures, postoperative leak, dumping syndrome, nutritional complications, and venous thromboembolic events. Presentation of case This report presents a case of perforation at the jejuno-jejunal (j-j) anastomosis, an extremely rare complication after laparoscopic RYGB surgery (LRYGBS), with an incidence reported to be under 1% in the literature. Potential causes noted from previous reports include distal obstruction, abscess formation, patient comorbidities, technical factors, and microbiological factors. A morbidly obese female patient underwent LRYGBS with an uneventful recovery. The patient presented 15 weeks postoperatively with a 2-day history of acute abdominal pain, vomiting, constipation, and peritoneal signs. Discussion Following clinical and radiological evaluation, the patient underwent an exploratory laparoscopy for the diagnosis and treatment of complications. In this case, laparoscopy was shifted to the open technique due to technical difficulties. A 1.5-cm perforation was identified at the site of the anastomosis and was repaired with absorbable sutures and a graham patch. The patient recovered uneventfully. Conclusion Prompt recognition of symptoms and early intervention may reduce overall morbidity and mortality in similar cases. This report describes a case of a late perforation at the site of j-j anastomosis in an obese female. We also discuss the incidence, presentation, management, outcome, and possible causes of such complications. |
| Databáze: | OpenAIRE |
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